This invention relates generally to a method and apparatus for biofeedback conditioning. More particularly, this invention relates to a device having audio and visual stimuli adapted to react to at least one parameter of the subject being evaluated, an iterative process being defined thereby with the audio and visual stimuli changing as a function of patient parameter variation.
Biofeedback represents an attempt to utilize the engineering principle of feedback control on human organisms. The importance of this control, from a psychological point of view, is that the functions to be controlled are those associated with the structures that determine the emotional status of the organism. However, whereas machines have a hard wired algorithm ("drive") to reduce the error signal, humans require a "voluntary" motivational drive to develop the algorithm that achieves the goal of physiological control. Hitherto used error signal means for presenting information have not been intrinsically motivating (i.e. nobody likes or dislikes a meter needle). Since development of those algorithms in human learning requires error-signal detection through feedback (stimulus discrimination) as well as optimum drive level through feedforward (motivation), it would be more efficient to manipulate both variables through the same feedback device.
The biofeedback process can be expressed in cybernetic terms as a system (the organism) provided with an external feedback loop and a transfer function which permits the efficient perception of the functions to be controlled. A man-machine symbiosis is established in this case, because the feedback loop transfer function is performed by electronic devices. It is this utilization of technology that has made possible the development of biofeedback, because the electronic devices can perform the detection, transformation and presentation of relevant information in a faster and easier to discriminate form than that which could be obtained by the organism's own means.
The field called visceral learning is studied using a mixture of theoretical frames of references derived from operant and "classical" conditioning. It could be argued that in the same way as the neuroendochrinal control system "learns" about the organism's external environment, it can also "learn" to control the internal environment.
In cybernetic terms, learning implies control. For a response to be stable, it must be first sensed or perceived and then compared with an internal performance reference. If it is not known what the organismm is sensing, one cannot determine what is being controlled to maintain a certain response. It is this inextricable relationship between perception and control that has been misinterpreted as a direct stimulus-response relationship, but it is needed to explain the relationship between external events and behavior.
Different types of devices have been used to present visual feedback information. All of them act by changing some perceptible visual characteristic as a function of the changes of the physiological parameter to be controlled. For instance, luminous indicators that change their intensities (analogic) or different indicators that turn on and off (binary) have been used. Nevertheless, the most utilized devices have been numeric indicators, like needle meters or digital displays.
The following citations reflect the state of the art of which applicant is aware insofar as these citations appear germane to the process at hand.
U.S. Pat. No. 3,967,616, Ross PA0 U.S. Pat. No. 3,991,304, Hillsman PA0 U.S. Pat. No. 4,014,323, Gilmer et al PA0 U.S. Pat. No. 4,184,485, Agoston PA0 U.S. Pat. No. 4,246,906, Winberg et al PA0 Brener, S., Sensory and perceptual determinants of voluntary visceral control. In G. E. Schwartz and J. Beatty (Eds.), Biofeedback Theory and Research. New York: Academic Press, 1977. PA0 Buckley, E. P. The man-machine system. In C. T. Morgan, A. Cahpanis, and M. W. Lund (Eds.), Human Engineering Guide to Equipment Design. New York: McGraw Hill, 1963. PA0 Cornsweet, T. N. Visual Perception. New York: Academic Press, 1970. PA0 Gearder, E. Control of states of consciousness. In E. Peper, S. Ancoli and M. Quinn (Eds.), Mind/Body Interaction. New York: Plenum Press, 1979. PA0 Hoon, E. E. Biofeedback-assisted sexual arousal in females, a comparison of visual and auditory modalities. Biofeedback and Self Regulation, 1980. 5-2, 175-191. PA0 Izard, C. E. The emergence of emotions and the development of consciousness in infancy. In J. M. Davidson and R. J. Davidson, (Eds.), The Psychology and Consciousness. New York: Plenum Press, 1980. PA0 John, E. R. Multipotenciality: A statistical theory of brain function-evidence and implications. In J. M. Davidson and R. J. Davidson (Eds.), The Psychology of Consciousness. New York: Plenum Press, 1980. PA0 Kimmel, H. D. The relevance or experimental studies to clinical applications of biofeedback. Biofeedback and Self-Regulation. Hillside, NJ: Erlbaum, 1979. PA0 Powers, W. T. Systems approach to consciousness. In J. M. Davidson and J. R. Davidson (Eds.), The Psychobiology of Consciousness. New York: Plenum Press, 1980. PA0 Stevens, S. S. Psychophysical law. In J. Cummings (Ed.), Encyclopedia of Psychology. New York: Herder and Herder, 1972.
Winberg et al is concerned with an apparatus for self-monitoring of physiological variables, in particular the temperature of a subject's hand. Provisions are made for the subject to hear and see respectively an audio and visual output which changes with respect to the monitored physiological variable. The termperature of the subject's fingertip is the preferred variable. The audible and visual indications are provided by a speaker 64 and a light-emitting diode 66 as shown in FIG. 1.
The patent to Agoston is concerned with a measuring arrangement for decreasing the emotional influence on instrumental diagnostical measurements which utilize a biofeedback arrangement which includes instrumentalities so that the tested person learns about the reduction in his pulse, for example, by noticing the increase in tone pitch in the audio output of the arrangement and by seeing the momentary pulse number on the dial of an indicator of the memory unit 8.
The patent to Ross proposes a multichannel system for controlling the nervous system of an organism by utilizing biofeedback. Here again, as can be seen from column 9 lines 44-48, one or more visual displays and/or auditory means such as one or more buzzers is used to indicate when the apparatus is in an inhibit mode. Thus, one set of transducing means 24 and another set of transducing means 124 are provided as portions of respective feedbacks.
Gilmer et al provides a system utilizing a low power level of pulsed alternating current for assisting a patient in producing an improved physiological or psychological condition within his body, and provides an electrotherapy treating unit with a biofeedback detecting and displaying unit for the patient's observation. Again, the stimuli defining an output from the biofeedback unit is a single pulsed frequency.
The patent to Hillsman includes preferred waveforms for breathing, monitoring of the breathing pattern, and the generation of a rectilinear raster display is employed for converting digital values in real time superimposed patterns.
None of these devices teach or render obvious either singly or in any conceivable combination that which is defined as the invention according to the instant application. The instant invention is distinguished thereover in that all of the citations are not intrinsically motivating nor more informative. In any case the only comparisons made have been between the informative properties of needle meters and digital numerical indicators, or between their binary and analogical characteristics.
In addition, auditory presentation devices have also been employed which in these cases, physiological information is presented by means of changes in intensity or frequency of pure tones (sine waves), or change in the repetition to audible "beeps". Moreover, the visual characteristics of the known prior art include observation of a needle meter or digital equivalent. There are equal lack of studies pertaining to optimum characteristics of discriminability as in the case of visual and audio stimuli. Usually the decision about which types of stimulus to utilize is arbitrary.
Biofeedback stimuli presently employed, therefore, are emotionally neuter, being neither intrinsically pleasant or aversive. Apparently, the process of control is simplified by presenting to the subject a purely informative stimulus that permits him to discriminate any change in the physiological parameters that are being controlled. Nevertheless, controlling the function implies learning and for it to occur, in addition to a discriminable stimulus, it is required that the subject be properly motivated.
The use of money as motivator has been a convenient way of standarizing the motivational level of subjects in research, be it paying them the same amount of money for their participation or giving them such amount contigent to their performance. Another motivator used in the same way as money has been the bonification of academic credits to subjects (participation is required as part of a course). For obvious reasons, the motivators mentioned cannot be used so effectively in the daily practice of biofeedback techniques (psychotherapy). In the clinical situation, the motivational problems are contemplated by the interaction between the client and the therapist.